Safe sleep for your baby

What is safe sleep?

Safe sleep means putting your baby to sleep in ways that can help protect him from dangers, like choking and suffocation (not being able to breathe), and sudden infant death syndrome (also called SIDS). SIDS is the unexplained death of a baby younger than 1 year old. SIDS usually happens when a baby is sleeping. It’s sometimes called crib death because the baby often dies in his crib.

How much sleep does your baby need?

Newborns sleep about 16 hours a day, usually in 3- to 4-hour periods. Your baby needs to eat every few hours, which is why she doesn’t sleep for longer periods of time. Your baby may get cranky or overtired if she doesn’t get enough sleep.

Don’t be surprised if your baby can only stay awake for an hour or two. Over time, her body gets into a sleep pattern. She starts sleeping for longer stretches, even during the night. If you’re worried about your baby’s sleep, talk to her health care provider.

Where should your baby sleep?  

The safest place for your baby to sleep is by herself in a bassinet or crib. If you have multiples (twins, triplets or more), put each baby in his own bassinet or crib. Here are some do’s and don’ts about making your baby’s sleep space safe:

Do’s

• Do put your baby to sleep on his back on a flat, firm surface, like a crib mattress covered with a tightly fitted sheet. Use only the mattress made for your baby’s crib. The mattress should fit snugly in the crib so there are no spaces between the mattress and the crib frame. The mattress shape should stay firm even when covered with a tightly fitted sheet or mattress cover.
• Do put your baby to bed in his own crib or bassinet. Don’t bed-share. This is when babies and parents sleep together in the same bed. Bed-sharing is the most common cause of death in babies younger than 3 months old. Keep your baby’s crib close to your bed so your baby’s nearby during the night. The American Academy of Pediatrics (also called AAP) recommends that you and your baby sleep in the same room, but not in the same bed, for the first year of your baby’s life but at least for the first 6 months
• Do make sure your baby’s bassinet, crib or play yard meets current safety standards. Visit the U.S. Consumer Product Safety Commission (CPSC) to learn more about product safety standards or product recalls.
• Do remove hanging window cords or electrical wires near where your baby sleeps. Babies can get tangled in them and choke. 
• Do keep the room at a comfortable temperature. If your baby is sweating or his chest feels hot, he may be overheated.

Don’ts

• Don’t use sleep positioners. These sometimes are called nests or anti-roll pillows. They often are mats or wedges with pillows on either side to help keep your baby in place. The Food and Drug Administration (also called FDA) warns that sleep positioners can cause babies to die because of suffocation.   
• Don’t let your baby sleep in a carrier, sling, car seat or stroller. Babies who sleep in these items can suffocate. If your baby falls asleep in one, take her out and put her in her crib as soon as you can.
• Don’t put your baby to sleep on soft surfaces, like a waterbed, sofa, soft mattress or cushion.
• Don’t keep crib bumpers, loose bedding, toys or other soft objects in your baby’s crib. They put your baby in danger of being trapped, strangled or suffocated.
• Don’t use cribs with drop-side rails. Don’t put portable bed rails on a regular bed. Babies can get stuck in rails and choke. Don’t try to fix a crib that has broken or missing parts.

How do you put your baby to sleep safely?

Here’s how to help keep your baby safe when you put her to sleep:

• Put your baby to sleep on his back every time until he’s 1 year old. It’s not safe for a baby to sleep on his side or tummy. If your baby can roll from his back to his side or tummy and back again, it’s OK if he changes positions while sleeping.
• Dress your baby in light sleep clothes. Remove any strings or ties from his pajamas and don’t cover his head. A blanket sleeper can help keep your baby warm without covering his head or face. It’s safe to swaddle your baby for sleep until he can roll over onto his tummy. But once he can roll over, stop swaddling. A swaddled baby who is placed on or rolls onto his tummy while sleeping may be more likely to experience SIDS. Swaddling is when you snugly wrap a light blanket around your baby so that it covers most of his body below the neck.   
• Give your baby a pacifier. Pacifiers may help protect against SIDS. If you’re breastfeeding, wait until your baby is 3 to 4 weeks old or until she’s used to breastfeeding before giving her a pacifier. If your baby won’t take a pacifier, don’t force it. It’s OK if the pacifier falls out of your baby’s mouth during sleep. Don’t hang the pacifier around your baby’s neck or attach the pacifier to your baby’s clothing or a stuffed animal. Give your baby a pacifier for naps and at bedtime.
• Don’t use home cardiorespiratory monitors as a way to reduce the risk of SIDS. These monitors track a baby’s heart rate and breathing. Some babies need this kind of monitor because of medical problems, but this is rare. There’s no evidence that the monitors help reduce the risk of SIDS in healthy babies.

How does breastfeeding affect safe sleep?

Breastfeeding for at least the first 6 of your baby’s life can reduce your baby’s risk of SIDS.

It’s OK to breastfeed your baby in your bed. Before you start feeding, move any bedding and pillows from your bed in case you fall asleep. If you do fall asleep, move your baby to his crib or bassinet as soon as you wake up. Breastfeeding your baby in bed is safer than on a sofa or cushioned chair.

Babies often fall asleep while breastfeeding, especially when they get full. If you think your baby’s asleep and hasn’t finished feeding, try to wake him gently by rubbing his back, tickling his feet, burping him or switching him to the other breast. If your baby’s not latched on correctly, he may fall asleep. You can break the latch by putting your pinky finger in the side of his mouth. Ask your lactation consultant to help you make sure your baby has a good latch. Latch is when your baby’s mouth is securely attached to the area around your nipple for breastfeeding. 

Are there other ways to help reduce your baby’s risk of sleep dangers, including SIDS?

Yes. Here’s what you can do:

• Make sure your baby gets all their vaccinations. These shots help protect her from serious childhood diseases and may help prevent SIDS. All children should be vaccinated for their own health and so they don’t spread infections to others.
• Don’t smoke and keep your baby away from other smokers and secondhand smoke (smoke from other people’s cigarettes, cigars and pipes). Babies who live with smokers are at increased risk of SIDS. Keep your home and your car smoke-free.
• Don’t smoke, drink alcohol or use harmful drugs during pregnancy. Babies of mothers who do these things are at increased risk of SIDS.  
• Go to all your prenatal care checkups during pregnancy. Babies of mothers who don’t get regular prenatal care are at increased risk of SIDS.

Can a bedtime routine help your baby sleep?

Yes. Your baby’s sleep schedule changes over time, but sticking to a routine can make bedtime easier for the both of you. Start setting a bedtime routine when your baby’s around 4 to 6 months old.

Here’s how to get your baby ready for bedtime:

• Wind down any playtime fun.
• Turn off the phone, television, etc.
• Give your baby a warm bath.
• Softly stroke your baby’s back.
• Give your baby a pacifier.
• Sing to your baby or play soft music.
• Read your baby a bedtime story.

Stick to your baby’s sleep routine as much as you can. Plan ahead if your baby’s routine may need a temporary change, like if you’re going out of town travel or attending family parties. Change his bed time the best you can but try to get back to his schedule and routine as soon as possible.

What is tummy time?

Tummy time is when you put your baby on her stomach while she’s awake. It can help make your baby’s neck, shoulder and arm muscles stronger. It also helps prevent flat spots on the back of your baby’s head that she may get from sleeping on her back. Always watch your baby during tummy time or make sure an adult who is awake is watching your baby.

Last reviewed: February, 2019